Celiac, Gluten Intolerance and Interstitial Cystitis

When Wendy Cohen RN, author of The Better Bladder Book, first suggested that gluten could trigger IC flares, many patients said “I told you so.” For several years, a small but significant group of patients have reported dramatic improvements in their IC symptoms after adopting a gluten free diet. The culprit may be Celiac Disease, a related condition to IC.

Celiac disease (aka celiac sprue) is a genetic, autoimmune disorder that effects that small intestine. When exposed to gluten proteins found in wheat and other grain crops, an inflammatory reaction occurs in the small bowel tissue. Symptoms include painful bloating, gas, chronic diarrhea, vomiting, constipation and weight loss. Atrophy the lining of the small intestine may interfere with food absorption, thus leading the vitamin deficiency and an increased risk of cancer. It may be that gluten proteins found in urine also trigger an inflammatory reaction in the bladder wall causing symptoms of urinary frequency, urgency, pressure and/or pain.

Diagnosis is often initially confused with irritable bowel syndrome. A simple blood test for transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA) can be performed. Occasionally, a physician may use an endoscopy to view the gut to look for tissue damage.

If your test is positive, you will be required to follow a gluten-free diet to heal your gut. If your test is negative, however, you may still feel better by removing many, if not most, gluten free products from your diet. This may be due to a sensitivity to gluten based products. You’ll need to experiment and see how you feel.

The IC & Gluten Free Diet

Asking an IC patient to remove gluten based foods is challenging. Breads, pastas, cookies are often the most comforting and soothing foods that patients feel that they can tolerate. Thankfully, a wide variety of gluten free flours, breads, baking products, cookies and pasta are now available. So, if you’ve come to depend on pasta, we encourage you to try Ancient Harvest Gluten Free Quinoa Pastas. If you love to bake, you’ll now find a wide variety of gluten free cookbooks and flours in many groceries stores. If you love pancakes and biscuits, Bisquick Gluten Free Pancake and Biscuit mix is excellent! More and more supermarkets now offer gluten free cookies and baked goods as well.

Products Containing Gluten

  • Wheat – wheat berries, durum, emmer, semolina, spelt, farina, farro, graham, KAMUT® khorasan wheat, einkorn wheat
  • Rye
  • Barley
  • Triticale
  • Malt – malted barley flour, malted milk or milkshakes, malt extract, malt syrup, malt flavoring, malt vinegar
  • Brewer’s Yeast
  • Wheat Starch

Foods Containing Gluten

  • Pastas – raviolis, dumplings, couscous, and gnocchi
  • Noodles – ramen, udon, soba (those made with only a percentage of buckwheat flour) chow mein, and egg noodles.
  • Breads and Pastries – croissants, pita, naan, bagels, flatbreads, cornbread, potato bread, muffins, donuts, rolls
  • Crackers – pretzels, goldfish, graham crackers
  • Baked Goods – cakes, cookies, pie crusts, brownies
  • Cereal & Granola – corn flakes and rice puffs often contain malt extract/flavoring, granola often made with regular oats, not gluten-free oats
  • Breakfast Foods – pancakes, waffles, french toast, crepes, and biscuits.
  • Breading & Coating Mixes – panko breadcrumbs
  • Croutons – stuffings, dressings
  • Sauces & Gravies that use flour as a thickener, traditional soy sauce, cream sauces made with a roux
  • Flour tortillas
  • Beer and any malt beverages
  • Brewer’s Yeast
  • Anything else that uses “wheat flour” as an ingredient

Other Items That May Contain Gluten

  • lipstick, lipgloss, and lip balm because they are unintentionally ingested
  • communion wafers
  • herbal or nutritional supplements
  • drugs and over-the-counter medications
  • vitamins & mineral supplements
  • play-dough

Suggested Reading